Certified Professional Coder/Biller

***This position is open through Friday, February 14th, 2025***

The Redding Rancheria is seeking a Certified Professional Coder/Biller. The preferred schedule for this position is Monday- Thursday 7:30 am to 5 pm and Fridays from 8 am to 2 pm.

JOB SUMMARY:

Perform all coding relating to Medical, Dental and accounts receivable. Coding for diagnosis, procedures and services performed by providers of the clinic. Audit for accuracy of billing for all 3rd Party Payers, Medi-Cal (including Medi-cal, Share of Cost) Medicare and Private Insurance meeting all payer, state and federal regulations.

REQUIREMENTS/MINIMUM QUALIFICATIONS:

• Must have current experience in Medical and/or Dental.
• Certified Professional Coder
• BS in Health Care Administration or equivalent years Coding/Billing experience
• Must pass pre-employment drug screening.
• Indian preference.

ESSENTIAL JOB DUTIES:

• Ensure coding, insurance and Alternate Resource Information is complete, current and determine eligibility.
• Read patient chart notes to verify correct CPT and/or CDT codes and ICD10 diagnosis codes. Communicate with providers to ensure timely completion of charting.
• Set claims to bill and communicate with RCM to ensure timely uploading of claim files to the clearinghouse.
• Assist Billing Manager and IT in monitoring fee schedules and recommend revisions when necessary.
• Audit Electronic Health Record (EHR) or Electronic Dental Records (EDR) for appropriate supporting documentation and medical necessity of documentation compared to charges.
• Determine accurate codes for diagnosis, procedures and services performed by Physicians and recognized nonphysician providers in a physician-based setting. (These services may include evaluation and management services as well as reviewing operative notes).
• Keep current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues.
• Providing physicians and staff with up-to-date coding information from reliable, accurate sources, such as specific payers, the AMA, AHA, ADA’s Coding Clinics and CMS.
• Communicate with admissions to ensure insurance and demographic information is correct.
• Communicate with Quality team to ensure documentation is meeting quality measures.
• Complete follow-up tasks of unpaid claims and research denials.
• Research proposed new procedures for coding and billing requirements as well as FQHC rules and regulations, update staff on findings.
• Run aging reports for all insurance categories, including no insurance, to ensure proper payments and RCM write offs.

A completed Redding Rancheria job application must be submitted in order to be considered for employment. You can fill out an application online at www.reddingrancheria-nsn.gov, please fax (530-242-4563) or email (employment@reddingrancheria-nsn.gov).

All certifications, credentials/ licenses, education verification /degrees and/or transcripts, and Indian verification are required to process your application.

Indian preference applies, but we welcome all applicants who wish to apply for this position. Certification of Native American heritage needs to be attached to the job application.

Any offer of employment is conditioned upon the successful completion of a pre-employment drug screen and criminal background screening clearance. All employees are required to submit to a Tuberculosis test (TB) test after they are hired in addition to being tested annually.

Additional Information:

In addition, Redding Rancheria offers an excellent benefit package containing Medical, Dental, Vision, Life Insurance and Short/Long Term disability, paid holidays, vacation and sick leave as well as a generous 401(k) retirement plan.

Redding Rancheria is a federally recognized Tribe with Pit River, Wintu and Yana people where pride in Tribal culture, history and identity is evident internally and in the larger community. Redding Rancheria is a leader in the constructive development of its people, the larger Indian community and the Redding region.

E-Verify Statement

Redding Rancheria participates in the Electronic Employment Verification Program. Visit the E-Verify URL below for more information.

https://www.e-verify.gov/employees

For further information, please contact Human Resources Dept. at (530) 225-8979.